Behavior therapy in retrospect: Patients' feelings about their behavior therapies.

Abstract

Fourteen behavior therapy patients were interviewed to determine if phenomena regularly observed in psychodynamic psychotherapies had occurred in their behavior therapies as well. Interview data were analyzed both statistically and clinically. Ratings by patients, their therapists, and the Es indicated that the prevalence of behavior modification techniques in the therapy was not significantly related to outcome, whereas a variety of the patients' personal feelings about their therapists were. Impressionistic analysis of the interviews also suggested that the important elements of these therapies were interpersonal ones, much as has been demonstrated in psychodynamic psychotherapy. The behavior modification techniques themselves seem to have added little to the therapies, and in some instances may even have facilitated continued defensive avoidance of problems.A careful reading of the proliferating behavior therapy literature reveals that the model of therapist and patient, rationally cooperating to the fullest in a straightforward, scientific enterprise, is met with only in theory and rarely, if ever, in actual practice. The observations of Klein, Dittmann, Parloff, and Gill (1969), for example, suggest that there is much more to the conduct of behavior therapy-at least as it is practiced by Wolpe and Lazarus--than is generally believed. If one pays close attention to patients' words and actions, as they are quoted or described in behavior therapy case reports, one is struck by the variety and intensity of feelings these treatments elicit, and the substantial portion of those feelings which is irrational, unreasonable, and even theoretically iconoclastic-precisely the same situation as exists in traditional, psychodynamic psychotherapy. Some of the authors who describe feelings which are similar to those arising in verbal psychotherapy include the following: Bond and Hutchison (1960), Carter (1968), Cooper, Gelder, and

Research on the Processes Involved in Treating Sexual Offenders

“…This authority was reassuring apparently because it gave the clients a sense of safety against potential aggression from other participants. In agreement with studies on other populations (Ryan & Gizynski, 1971;Schindler, Hohenberger-Sieber, & Hahlweg, 1989), the patients' definition of a good therapist involved confidence, strength, competence, and persuasiveness when necessary.…”

The Impact of Interpersonal Patient and Therapist Behavior on Outcome in Cognitive-Behavior Therapy

“…In five retrospective studies, patients were asked what they felt had been the most helpful aspect of their cognitive-behavioral treatment (Llewelyn & Hume, 1979;Murphy, Cramer, & Lillie, 1984;Ryan & Gizynski, 1971;Sloane, Staples, Whipple, & Cristol, 1977;van Beek, 1996). All five studies consistently reported that patients had found the relationship with their therapist more helpful than the cognitivebehavioral techniques that were employed.…”

“…When patients who have completed cognitivebehavioral treatment are asked to indicate what had helped them the most to overcome their problems, they will answer "talking with somebody who listens and understands." (Llewelyn & Hume, 1979;Murphy et al, 1984;Ryan & Gizynski, 1971;Sloane et al, 1977;van Beek, 1996). …”

Potency in Psychotherapy

“…By obtaining reports from clients rather than therapists, they were able to show that what happens in behaviour therapy and in traditional psychodynamic treatment has more in common than most behaviour therapists like to suppose. (Ryan and Gizynski, 1971). The latter, at times, seem to make great efforts to give the appearance of engaging in a scientific exercise.…”